Airflow Obstruction and Use of Solid Fuels for Cooking or Heating BOLD (Burden of Obstructive Lung Disease) Results

作者：Amaral Andre F S; Patel Jaymini; Kato Bernet S; Obaseki Daniel O; Lawin Herve; Tan Wan C; Juvekar Sanjay K; Harrabi Imed; Studnicka Michael; Wouters Emiel F M; Loh Li Cher; Bateman Eric D; Mortimer Kevin; Buist A Sonia; Burney Peter G J

来源：American Journal of Respiratory and Critical Care Medicine, 2018, 197(5): 595-610.

DOI：10.1164/rccm.201701-0205OC

• chronic obstructive pulmonary disease
• airflow obstruction
• solid fuels (biomass)
• low-income countries

Rationale: Evidence supporting the association of chronic obstructive pulmonary disease or airflow obstruction with use of solid fuels is conflicting and inconsistent.
Objectives: To assess the association of airflow obstruction with self-reported use of solid fuels for cooking or heating.
Methods: We analyzed 18,554 adults from the BOLD (Burden of Obstructive Lung Disease) study, who had provided acceptable post-bronchodilator spirometry measurements, and information on use of solid fuels. The association of airflow obstruction with use of solid fuels for cooking or heating was assessed by sex, within each site, using regression analysis. Estimates were stratified by national income and meta-analyzed. We performed similar analyses for spirometric restriction, chronic cough, and chronic phlegm.
Measurements and Main Results: We found no association between airflow obstruction and use of solid fuels for cooking or heating (odds ratio [OR] formen, 1.20 [95% confidence interval (CI), 0.94-1.53]; OR for women, 0.88 [95% CI, 0.67-1.15]). This was true for low-/middle- and high-income sites. Among never-smokers, there was also no evidence of an association of airflow obstruction with use of solid fuels (OR for men, 1.00 [95% CI, 0.57-1.76]; ORfor women, 1.00 [95% CI, 0.76-1.32]). Overall, we found no association of spirometric restriction, chronic cough, or chronic phlegm with the use of solid fuels. However, we found that chronic phlegm was more likely to be reported among female never-smokers and those who had been exposed for 20 years or longer.
Conclusions: Airflow obstruction assessed from post-bronchodilator spirometry was not associated with use of solid fuels for cooking or heating.

• 出版日期2018-3-1